The oncogenic effect of ionizing radiation is widely known. Sarcomas developing after radiation therapy (RT), termed “iatrogenic disease of success”, represent a growing problem, since the advancements in cancer management and screening programs have increased the number of long-term cancer survivors. Although many patients have been treated with radiation therapy, only few data are available on radiation-induced sarcomas (RIS).

We examined the medical and radiological records of 186 patients with histologically proven soft tissue and bone sarcomas, which referred to IRCCS CROB Centro di Riferimento Oncologico della Basilicata from January 2009 to May 2022. Among them, seven patients received a histological diagnosis of secondary RIS, according to Cahan’s criteria. Clinicopathological features and treatment follow-up data of RIS patients were retrospectively analyzed.

Among these secondary RIS, five arose in irradiated breast cancer (5/2,570, 0.19%) and two in irradiated head and neck cancer (2/1,986, 0.10%) patients, with a mean onset latency time of 7.3 years. The histology of RIS was one desmoid tumor, two angiosarcomas, one chondrosarcoma, two leiomyosarcomas, and one undifferentiated pleomorphic sarcoma. Out of the seven RIS, one received radiotherapy, one received electrochemotherapy (ECT), one received a second-line chemotherapy, three were subjected to three lines of chemotherapy, and one underwent radiofrequency ablation, chemotherapy, and ECT. Median survival time is 36 months. No significant survival differences were found stratifying patients for age at RT, latency time, and age at RIS diagnosis.

RIS represents a possible complication for long-survivor cancer patients. Therefore, adherence to a strict follow-up after the radiation treatment is recommended to allow early diagnosis and optimal management of RIS patients. After the planned follow-up period, considering the long-term risk to develop a RIS, a specific multispecialty survivorship care plan could be of benefit for patients.

电离辐射的致癌作用是众所周知的。放射治疗 (RT) 后发生的肉瘤，被称为“成功的医源性疾病”，代表了一个日益严重的问题，因为癌症管理和筛查计划的进步增加了长期癌症幸存者的数量。尽管许多患者接受了放射治疗，但关于放射诱导肉瘤 (RIS) 的数据很少。

我们检查了 2009 年 1 月至 2022 年 5 月 IRCCS CROB Centro di Riferimento Oncologico della Basilicata 的 186 例经组织学证实的软组织和骨肉瘤患者的医学和放射学记录。其中，7 例患者的组织学诊断为继发性 RIS，根据卡汉的标准。回顾性分析RIS患者的临床病理特征及治疗随访资料。

在这些继发性 RIS 中，有 5 例发生在放射治疗的乳腺癌（5/2,570, 0.19%）和 2 例发生在放射治疗的头颈癌（2/1,986, 0.10%）患者中，平均发病潜伏期为 7.3 年。 RIS的组织学为1个硬纤维瘤、2个血管肉瘤、1个软骨肉瘤、2个平滑肌肉瘤和1个未分化多形性肉瘤。7个RIS中，1个接受了放疗，1个接受了电化疗（ECT），1个接受了二线化疗，3个接受了三线化疗，1个接受了射频消融、化疗和ECT。中位生存时间为 36 个月。在 RT 年龄、潜伏时间和 RIS 诊断年龄对患者进行分层时，没有发现显着的生存差异。

RIS 代表了长期存活癌症患者可能出现的并发症。因此，建议在放射治疗后坚持严格的随访，以便对 RIS 患者进行早期诊断和最佳管理。在计划的随访期之后，考虑到发展 RIS 的长期风险，一个特定的多专科生存护理计划可能对患者有益。